<form class="form-horizontal" role="form" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">供应商</label>
        <div class="col-xs-12 col-sm-8">
            <input class="form-control selectpage" name="row[finish_shop_id]" value="{$row.finish_shop_id??0}"
                   data-source="vv/supply/index"
                   data-params='{"custom[status]":"normal","custom[shoptype]":2}'
                   data-primary-key="id"
                   data-field="shopname"
                   data-pagination="true"
                   data-page-size="10"
                   data-multiple="false"
                   data-max-select-limit="5"
            >
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">类型</label>
        <div class="col-xs-12 col-sm-8">
            {:Form::radios('row[type]',[1=>'电子普通发票',2=>'专用发票'])}
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">发票抬头</label>
        <div class="col-xs-12 col-sm-8">
            {:Form::radios('row[title]',[1=>'个人',2=>'单位'],1)}
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">个人或单位名称</label>
        <div class="col-xs-12 col-sm-8">
            <input class="form-control" name="row[name]" value="{$row.name??''}">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">发票内容</label>
        <div class="col-xs-12 col-sm-8">
            <input class="form-control" name="row[content]" value="{$row.content??''}">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">收票人手机</label>
        <div class="col-xs-12 col-sm-8">
            <input class="form-control" name="row[mobile]" value="{$row.mobile??''}">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">收票人邮箱</label>
        <div class="col-xs-12 col-sm-8">
            <input class="form-control" name="row[email]" value="{$row.email??''}">
        </div>
    </div>

    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
